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Individual

KEVIN M. KRIPPNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
403 W VIRGINIA AVE, NORMAL, IL 61761-3666
(309) 268-5547
(309) 268-2913
Mailing address
403 W VIRGINIA AVE, NORMAL, IL 61761-3666
(309) 268-5547
(309) 268-2913

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
071004205
IL
103TC0700X
Clinical Psychologist
Primary
071004205
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05732028
BLUE CROSS BLUE SHIELD
Enumeration date
07/25/2006
Last updated
10/26/2015
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